Advertisement

Journal of Cross-Cultural Gerontology

, Volume 28, Issue 2, pp 137–152 | Cite as

Patterns of Caregiving of Cuban, Other Hispanic, Caribbean Black, and White Elders in South Florida

  • Marie-Luise Friedemann
  • Kathleen C. Buckwalter
  • Frederick L. Newman
  • Ana C. Mauro
ORIGINAL ARTICLE

Abstract

Caregivers in Miami, Florida (185 Cubans, 108 other Hispanics, 229 non-Hispanic Whites, and 73 Caribbean Blacks) were described and compared along demographic and health variables, cultural attitudes, and caregiving behaviors. Participants were recruited at random through Home Health Services (61 %) and convenience sampling in the community (39 %), and interviewed at their home. Standardized instruments and measures constructed for this study were pretested. Multivariate analyses showed that the ethnic groups differed in age, education, income, and number of persons giving care, while caregiver health and patient functioning were similar. Controlling for demographics, differences in cultural variables were small. The sense of obligation, emotional attachment, openness about who should give care, spirituality, use of family help or community services were comparable in all groups. Commitment to caregiving was high, driven mainly by patient needs. Cubans had the greatest family stability, and worked the hardest, with the lowest sense of burden. Caribbean Black caregivers lived in bigger families, were youngest, and their patients had the lowest cognitive status. Burden was felt most by White caregivers who were older than the others. Professionals need to understand complex belief systems and behavior patterns to assist caregivers in mobilizing appropriate resources.

Keywords

Family caregiving Ethnic differences Culture Family stability Family growth Cuban Hispanic Caribbean Black 

Notes

Acknowledgment

This study was supported by Florida International University MBRS grant, SCORE Project NIHSO6GM08205, National Institutes of Health, National Institute of General Medical Sciences.

References

  1. Adams, C. E., Horn, K., & Bader, J. (2006). Hispanic access to hospice services in a predominantly Hispanic community. The American Journal of Hospice & Palliative Care, 22(1), 9–16.CrossRefGoogle Scholar
  2. Anderson, J. R., & Turner, W. L. (2010). When caregivers are in need of care: African-American caregivers’ preferences for their own later life care. Journal of Aging Studies, 24, 65–73.CrossRefGoogle Scholar
  3. Angel, J. L., Angel, R. J., Aranda, M. P., & Miles, T. P. (2004). Can the family still cope? Social support and health as determinants of nursing home use in the older Mexican-origin population. Journal of Aging and Health, 16(3), 338–354.CrossRefGoogle Scholar
  4. Bee, P. E., Barnes, P., & Luker, K. A. (2009). A systematic review of informal caregivers’ needs in providing home-based end-of-life care to people with cancer. Journal of Clinical Nursing, 18, 1379–1393.CrossRefGoogle Scholar
  5. Calderón-Rosado, V., Morrill, A., Chang, B. H., & Tennstedt, S. (2002). Service utilization among disabled Puerto Rican elders and their caregivers: does acculturation play a role? Journal of Aging and Health, 14, 3–23.CrossRefGoogle Scholar
  6. Casado, B. L., van Vulpen, K. S., & Davis, S. L. (2011). Unmet needs for home and community-based services among frail older Americans and their caregivers. Journal of Aging and Health, 23, 529–533.CrossRefGoogle Scholar
  7. Clark, A. N., Sander, A. M., Pappadis, M. R., Evans, G. L., Struchen, M. A., & Chiou-Tan, F. Y. (2010). Caregiver characteristics and their relationship to health service utilization in minority patients with first episode stroke. NeuroRehabilitation, 27, 95–104.Google Scholar
  8. Cooper, C., Tandy, A. R., Balamurali, T. B., & Livingston, G. (2010). A systematic review and meta-analysis of ethnic differences in use of dementia treatment, care, and research. The American Journal of Geriatric Psychiatry, 18(3), 193–203.CrossRefGoogle Scholar
  9. Dilworth-Anderson, P., Williams, I., & Gibson, B. (2002). Issues of race, ethnicity, and culture in caregiving research: a 20-year review (1980–2000). The Gerontologist, 42(2), 237–272.CrossRefGoogle Scholar
  10. Dilworth-Anderson, P., Brummett, B. H., Goodwin, P., Wallace Williams, S., Williams, R. B., & Siegler, I. C. (2005). Effect of race on cultural justifications for caregiving. Journal of Gerontology: Social Sciences, 60B, S257–S262.CrossRefGoogle Scholar
  11. Drapalski, A. L., Marshall, T., Seybolt, D., Medoff, D., Peer, J., Leith, J., et al. (2008). Unmet needs of families of adults with mental illness and preferences regarding family services. Psychiatric Services, 59, 655–662.CrossRefGoogle Scholar
  12. Dunlop, D., Manheim, L., Song, J., & Chang, R. (2002). Gender and ethnic/racial disparities in health care utilization among older adults. Journal of Gerontology: Social Sciences, 57B(3), S221–S233.CrossRefGoogle Scholar
  13. Family Caregiver Alliance, National Center on Caregiving (2006). http://www.caregiver.org/caregiver/jsp/print_friendly.jsp?nodeid=1822. Fact Sheet: Caregiver Health.
  14. Feld, S., Dunkle, R. E., & Schroepfer, T. (2004). Race/ethnicity and marital status in IADL caregiver network. Research on Aging, 26, 531–558.CrossRefGoogle Scholar
  15. Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-mental state. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
  16. Fredman, L., Cauley, J. A., Satterfield, S., Simonsick, E., Spencer, S. M., Ayonayon, H. N., et al. (2008). Caregiving, mortality, and mobility decline: the health, aging, and body composition (Health ABC) study. Archives of Internal Medicine, 168, 2154–2162.CrossRefGoogle Scholar
  17. Friedemann, M. L. (1991). An instrument to evaluate effectiveness of family functioning. Western Journal of Nursing Research, 13(2), 220–236.CrossRefGoogle Scholar
  18. Friedemann, M. L. (1995). The framework of systemic organization: A conceptual approach to families and nursing. Thousand Oaks: Sage Publications, Inc.Google Scholar
  19. Hinojosa, M. S., Rittman, M., & Hinojosa, R. (2009). Informal caregivers and racial/ethnic variation in health service use of stroke survivors. Journal of Rehabilitation Research and Development, 46(2), 233–242.CrossRefGoogle Scholar
  20. Huang, F. Y., Chung, H., Kroenke, K., Deluchi, K. L., & Spitzer, R. L. (2006). Using the Patient Health Questionnaire-9 to measure depression among racially and ethnically diverse primary care patients. Journal of General Internal Medicine, 21, 547–552.CrossRefGoogle Scholar
  21. Karlin, N. J., Eguigure, A., & Torres, A. (2009). Hispanic family members and caring for those with Alzheimer’s Disease. Alzheimer’s Care Today, 10(4), 191–203.Google Scholar
  22. Kaufman, A. V., Kosberg, J. I., Leeper, J. D., & Tang, M. (2010). Social support, caregiver burden, and life satisfaction in a sample of rural African-American and White caregivers of older persons with dementia. Journal of Gerontological Social Work, 53, 251–269.CrossRefGoogle Scholar
  23. Kosloski, K., Schaefer, J. P., Allwardt, D., Montgomery, R. J., & Karner, T. X. (2002). The role of cultural factors on clients’ attitudes toward caregiving, perceptions of service delivery, and service utilization. Home Health Care Services Quarterly, 21(3/4), 65–88.CrossRefGoogle Scholar
  24. Kutner, J., Kilbourn, K. M., Costerano, A., Lee, C. A., Nowels, C., Vancura, J. L., et al. (2009). Support needs of informal hospice caregivers: a qualitative study. Journal of Palliative Medicine, 12, 1101–1104.CrossRefGoogle Scholar
  25. Mausbach, B. T., Coon, D. W., Depp, C., Rabinowitz, Y. G., Wilson-Arias, E., Kraemer, H. C., et al. (2004). Ethnicity and time to institutionalization of dementia patients: a comparison of Latina and Caucasian female family caregivers. Journal of American Geriatrics Society, 52(7), 1077–1084.CrossRefGoogle Scholar
  26. Min, J. W., & Barrio, C. (2009). Cultural values and caregiver preference for Mexican-American and non-Latino White elders. Journal of Cross-Cultural Gerontology, 24, 225–239.CrossRefGoogle Scholar
  27. Montgomery, R. J., & Borgotta, E. F. (1985). Family Support Project. Final report to the Administration on Aging. Seattle, WA: University of Washington, Institute on Aging/Long-term Care Center.Google Scholar
  28. Montgomery, R. J., & Borgotta, E. F. (1989). The effects of alternative support strategies on family caregiving. The Gerontologist, 29, 457–464.CrossRefGoogle Scholar
  29. Montgomery, R. J., & Kosloski, C. (2001). Executive summary: AOA further analysis and evaluation of the ADDGS project. Lawrence: Gerontology Center, University of Kansas.Google Scholar
  30. Montgomery, R. J., Stull, D. E., & Borgotta, E. F. (1985). Measurement and the analysis of burden. Research on Aging, 7, 137–152.CrossRefGoogle Scholar
  31. Morano, C. L., & King, D. (2005). Religiosity as a mediator of caregiver well-being. Journal of Gerontological Social Work, 45(1–2), 69–84.CrossRefGoogle Scholar
  32. Napoles, A. M., Chadiha, L., Eversley, R., & Moreno, J. (2010). Developing culturally sensitive dementia caregiver interventions: are we there yet? American Journal of Alzheimer’s Disease and Other Dementias, 25(5), 389–406.CrossRefGoogle Scholar
  33. Navaie-Waliser, M., Feldman, P. H., Gould, D. A., Levine, C., Kuerbis, A. N., & Doneland, K. (2001). The experiences and challenges of informal caregivers. The Gerontologist, 41, 733–741.CrossRefGoogle Scholar
  34. Nelson-Becker, H. (2005). Religion and coping in older adults: a social work perspective. Journal of Gerontological Social Work, 45(1/2), 51–67.CrossRefGoogle Scholar
  35. Pinquart, M., & Sorensen, S. (2005). Ethnic differences in stressors, resources, and psychological outcomes of family caregiving: a meta-analysis. The Gerontologist, 45(1), 90–106.CrossRefGoogle Scholar
  36. Radina, M. E., & Barber, C. E. (2004). Utilization of formal support services among Hispanic Americans caring for aging parents. Journal of Gerontological Social Work, 43(2–3), 5–23.CrossRefGoogle Scholar
  37. Reed, P. G. (1986). Religiousness among terminally ill and healthy adults. Research in Nursing & Health, 9, 35–41.CrossRefGoogle Scholar
  38. Robinson, K. M., Buckwalter, K. C., & Reed, D. (2005). Predictors of use of services among dementia caregivers. Western Journal of Nursing Research, 27(2), 126–140.CrossRefGoogle Scholar
  39. Roth, D. L., Haley, W. E., Wadley, V. G., Clay, O. J., & Howard, G. (2007). Race and gender differences in perceived availability for community-dwelling middle-aged and older adults. The Gerontologist, 47, 721–729.CrossRefGoogle Scholar
  40. Roth, D. L., Ackerman, M. L., Okonkwo, O. C., & Burgio, L. D. (2008). The four-factor model of depressive symptoms in dementia caregivers: a structural equation model of ethnic differences. Psychological Aging, 23, 567–576.CrossRefGoogle Scholar
  41. Savundranayagam, M. Y., & Montgomery, R. J. (2010). Impact of role discrepancies on caregiver burden among spouses. Research on Aging, 32(2), 175–199.CrossRefGoogle Scholar
  42. Savundranayagam, M. Y., Montgomery, R. J., & Kosloski, K. (2011). A dimensional analysis of caregiver burden amoung spouses and adult children. The Gerontologist, 51, 321–331.CrossRefGoogle Scholar
  43. Scharlach, A. E., Kellam, R., Ong, N., Baskin, A., Goldstein, C., & Fox, P. J. (2006). Cultural attitudes and caregiver resource use: lessons from focus groups with racially and ethnically diverse family caregivers. Journal of Gerontological Social Work, 47(1/2), 133–156.CrossRefGoogle Scholar
  44. Scharlach, A. E., Gustavson, K., & Dal Santo, T. S. (2007). Assistance received by employed caregivers and their care recipients: who helps care recipients when caregivers work full time? The Gerontologist, 47(6), 752–762.CrossRefGoogle Scholar
  45. Scharlach, A. E., Giunta, N., Chun-Chung Chow, J., & Lehning, A. (2008). Racial and ethnic variations in caregiver service use. Journal of Aging and Health, 20(3), 326–346.CrossRefGoogle Scholar
  46. Schubart, J. R., Kinzie, M. B., & Farace, E. (2007). Caring for the brain tumor patient: family caregiver burden and unmet needs. Neuro-Oncology, 10, 61–72.CrossRefGoogle Scholar
  47. Segre, L. S., Buckwalter, K. C., & Friedemann, M. L. (2011). Strategies to engage clinical staff in subject recruitment. Journal of Research in Nursing, 16, 321–332.CrossRefGoogle Scholar
  48. Siefert, M. L., Williams, A., Dowd, M. F., Chappel-Aiken, L., & McCorkle, R. (2008). The caregiver experience in a racially diverse sample of cancer family caregivers. Cancer Nursing, 31(5), 399–407.CrossRefGoogle Scholar
  49. Sorensen, S., & Pinquart, M. (2005). Racial and ethnic differences in the relationship of caregiver stressors, resources, and sociodemographic variables to caregiver depression and perceived physical health. Aging & Mental Health, 9(5), 482–495.CrossRefGoogle Scholar
  50. U. S. Census Bureau (2009). http://www.census.gov/population/www/projections/summarytables.html, Summary Table: Projections of the Population by Selected Age Groups and Sex for the United States: 2010 to 2050.

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Marie-Luise Friedemann
    • 1
  • Kathleen C. Buckwalter
    • 2
  • Frederick L. Newman
    • 3
  • Ana C. Mauro
    • 4
  1. 1.College of Nursing and Health SciencesFlorida International UniversityMiami LakesUSA
  2. 2.College of NursingThe University of IowaIowa CityUSA
  3. 3.Stempel School of Public HealthFlorida International UniversityKansas CityUSA
  4. 4.College of Nursing and Health SciencesFlorida International UniversityChicagoUSA

Personalised recommendations